Pharmaceutical agents for treatment of urinary incontinence

ABSTRACT

The present invention relates to a method of treating or preventing urinary incontinence in mammals, including humans, using certain quinuclidine derivatives, piperidine derivatives, azanorbornane derivatives and related compounds.

BACKGROUND OF THE INVENTION

The present invention relates to a method of treating or preventing urinary incontinence in mammals, including humans, using certain quinuclidine derivatives, piperidine derivatives, azanorbornane derivatives, ethylene diamine derivatives and related compounds. The pharmaceutically active compounds employed in this invention are substance P receptor antagonists.

The following references refer, collectively, to quinuclidine, piperidine, and azanorbornane derivatives and related compounds that exhibit activity as substance P receptor antagonists: U.S. Pat. No. 5,162,339, which issued on Nov. 11, 1992; U.S. patent application Ser. No. 724,268, filed Jul. 1, 1991; PCT Patent Application PCT/US 91/02853, filed Apr. 25, 1991; PCT Patent Application PCT/US 91/03369, filed May 14, 1991; PCT Patent Application PCT/US 91/05776, filed Aug. 20, 1991; PCT Patent Application PCT/US 92/00113, filed Jan. 17, 1992; PCT Patent Application PCT/US 92/03571, filed May 5, 1992; PCT Patent Application PCT/US 92/03317, filed Apr. 28, 1992; PCT Patent Application PCT/US 92/04697, filed Jun. 11, 1992; U.S. patent application Ser. No. 766,488, filed Sep. 26, 1991; U.S. patent application Ser. No. 790,934, filed Nov. 12, 1991; PCT Patent Application PCT/US 92/04002, filed May 19, 1992; Japanese Patent Application 065337/92, filed Mar. 23, 1992; U.S. patent application Ser. No. 932,392, filed Aug. 19, 1992; and U.S. patent application Ser. No. 988,653, filed Dec. 10, 1992.

SUMMARY OF THE INVENTION

The present invention relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal an amount of a compound of the formula ##STR1##

wherein A is a ring system selected from phenyl, naphthyl, thienyl, quinolinyl and indolinyl, and wherein the sidechain containing NR² R³ is attached to a carbon atom of ring system A;

AA is an aryl group selected from phenyl, naphthyl, thienyl, dihydroquinolinyl and indolinyl, and wherein the sidechain containing NR² R³ is attached to a carbon atom of AA;

W^(l) is hydrogen, halo or (C₁ -C₆) alkyl, S--(C₁ -C₃)alkyl, halo or (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms.

W is hydrogen, (C₁ -C₆)alkyl optionally substituted with from one to three fluorine atoms, --S(O)_(v) --(C₁ -C₆) alkyl wherein v is zero, one or two, halo or (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms;

X¹ is hydrogen, (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms or (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms;

X² and X³ are independently selected from hydrogen, halo, nitro, (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms, trifluoromethyl, hydroxy, phenyl, cyano, amino, ##STR2##

R is a 4, 5 or 6 membered heterocyclic ring containing from one to three heteroatoms selected from oxygen, nitrogen and sulfur (e.g., thiazolyl, azetidinyl, pyrrolyl, pyrazolyl, 1,2,3-triazolyl, 1,2,4-triazolyl, isothiazolyl, imidazolyl, isoxazolyl, or oxazolyl) wherein said heterocyclic ring may contain from zero to three double bonds and may optionally be substituted with one or more substituents, preferably one or two substituents, independently selected from (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms and (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms;

R¹ is selected from amino, (C₁ -C₆)alkylamino, di-(C₁ -C₆)alkylamino, --S(O)_(v) --(C₁ -C₁₀)-alkyl wherein v is zero, one or two, --S(O)_(v) -aryl wherein v is zero, one or two, --O-aryl, --SO₂ NR⁴ R⁵ wherein each of R⁴ and R⁵ is, independently, (C₁ -C₆)alkyl, or R⁴ and R⁵, together with the nitrogen to which they are attached, form a saturated ring containing one nitrogen and from 3 to 6 carbons, ##STR3## wherein one or both of the alkyl moieties may optionally be substituted with from one to three fluorine atoms, ##STR4## and wherein the aryl moieties of said --S(O)_(v) -aryl, --O-aryl and ##STR5## are independently selected from phenyl and benzyl and may optionally be substituted with from one to three substituents independently selected from (C₁ -C₄)alkyl, (C₁ -C₄)alkoxy and halo;

or R¹ is a group having the formula ##STR6## wherein a is 0, 1 or 2 and the asterisk represents a position meta to the R² R³ NCH₂ side chain;

the dotted lines in formula Ib represent that one of the X-Y and Y-Z bonds may optionally be a double bond;

X is selected from ═CH--, --CH₂ --, --O--, --S--, --SO--, --SO₂ --, --N(R⁴)--, --NH--, ═N--, --CH[(C₁ -C₆)alkyl]--, ═C[(C₁ -C₆)alkyl]--, --CH(C₆ H₅)-- and ═C(C₆ H₅)--;

Y is selected from C═O, C═NR⁴, C═S, ═CH--, --CH₂ --, ═C[(C₁ -C₆)alkyl]--, --CH[(C₁ -C₆)alkyl]--, ═C(C₆ H₅)--, --CH(C₆ H₅)--, ═N--, --NH--, --N(R⁴)--, ═C(halo)--, ═C(OR⁴)--, ═C(SR⁴)--, ═C(NR⁴)--, --O--, --S-- and SO₂, wherein the phenyl moieties of said ═C(C₆ H₅)-- and --CH(C₆ H₅)-- may optionally be substituted with from one to three substituents independently selected from trifluoromethyl and halo, and wherein the alkyl moieties of said ═[(C₁ -C₆)alkyl]-- and --CH[C₁ -C₆)alkyl]-- may optionally be substituted with from one to three fluorine atoms;

Z is selected from ═CH--, --CH₂ --, ═N--, --NH--, --S--, --N(R⁴)--, ═CH(C₆ H₅)--, --CH(C₆ H₅)--, ═C[(C₁ -C₆)alkyl]-- and --CH[(C₁ -C₆)alkyl]--;

or X, Y and Z, together with the two carbon atoms shared between the benzo ring and the XYZ ring, form a fused pyridine or pyrimidine ring;

R⁴ is (C₁ -C₆) alkyl or phenyl;

R² is hydrogen or --CO₂ (C₁ -C₁₀) alkyl;

R³ is selected from ##STR7## wherein R⁶ and R¹⁰ are independently selected from furyl, thienyl, pyridyl, indolyl, biphenyl and phenyl, wherein said phenyl may optionally be substituted with one or two substituents independently selected from halo, (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms, carboxy, benzyloxycarbonyl and (C₁ -C₃) alkoxy-carbonyl;

R⁷ is selected from (C₃ -C₄) branched alkyl, (C₅ -C₆) branched alkenyl, (C₅ -C₇) cycloalkyl, and the radicals named in the definition of R⁶ ;

R⁸ is hydrogen or (C₁ -C₆) alkyl;

R⁹ and R¹⁹ are independently selected from phenyl, biphenyl, naphthyl, pyridyl, benzhydryl, thienyl and furyl, and R⁹ and R¹⁹ may optionally be substituted with from one to three substituents independently selected from halo, (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms and (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms;

Y¹ is (CH₂)₁ wherein 1 is an integer from one to three, or Y¹ is a group of the formula ##STR8##

Z¹ is oxygen, sulfur, amino, (C₁ -C₃)alkylamino or (CH₂)_(n) wherein n is zero, one or two;

x is an integer from zero to four;

y is an integer from zero to four;

z is an integer from one to six, wherein the ring containing (CH₂)_(z) may contain from zero to three double bonds, and one of the carbons of (CH₂)_(z) may optionally be replaced by oxygen, sulfur or nitrogen;

o is two or three;

p is zero or one;

r is one, two or three;

R¹¹ is thienyl, biphenyl or phenyl optionally substituted with one or two substituents independently selected from halo, (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms and (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms;

X⁴ is (CH₂)_(q) wherein q is an integer from 1 to 6, and wherein any one of the carbon-carbon single bonds in said (CH₂)_(q) may optionally be replaced by a carbon-carbon double bond, and wherein any one of the carbon atoms of said (CH₂)_(q) may optionally be substituted with R¹⁴, and wherein any one of the carbon atoms of said (CH₂)_(q) may optionally be substituted with R¹⁵ ;

m is an integer from 0 to 8, and any one of the carbon-carbon single bonds of (CH₂)_(m), wherein both carbon atoms of such bond are bonded to each other and to another carbon atom in the (CH₂)_(m), chain, may optionally be replaced by a carbon-carbon double bond or a carbon-carbon triple bond, and any one of the carbon atoms of said (CH₂)_(m) may optionally be substituted with R¹⁷ ;

R¹² is a radical selected from hydrogen, (C₁ -C₆) straight or branched alkyl, (C₃ -C₇) cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from biphenyl, phenyl, indanyl and naphthyl; heteroaryl selected from thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl-(C₂ -C₆) alkyl, benzhydryl and benzyl, wherein the point of attachment on R¹² is a carbon atom unless R¹² is hydrogen, and wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl-(C₂ -C₆)alkyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms, amino, hydroxy-(C₁ -C₆)alkyl, (C₁ -C₆)alkoxy-(C₁ -C₆)alkyl, (C₁ -C₆)-alkylamino, ##STR9## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl;

R¹³ is hydrogen, phenyl or (C₁ -C₆)alkyl;

or R¹² and R¹³, together with the carbon to which they are attached, form a saturated carbocyclic ring having from 3 to 7 carbon atoms wherein one of said carbon atoms that is neither the point of attachment of the spiro ring nor adjacent to it may optionally be replaced by oxygen, nitrogen or sulfur;

R¹⁴ and R¹⁵ are each independently selected from hydrogen, hydroxy, halo, amino, oxo (═O), cyano, hydroxy-(C₁ -C₆)alkyl, (C₁ -C₆)alkoxy-(C₁ -C₆)alkyl, (C₁ -C₆)alkylamino, ##STR10## and the radicals set forth in the definition of R¹² ; ##STR11## NHCH₂ R¹⁸, SO₂ R¹⁸, GR²⁰ CO₂ H or one of the radicals set forth in any of the definitions of R¹², R¹⁴ and R¹⁵ ;

R¹⁷ is oximino (═NOH) or one of the radicals set forth in any of the definitions of R¹², R¹⁴ and R¹⁵ ; and

R¹⁸ is (C₁ -C₆) alkyl, hydrogen, phenyl or phenyl (C₁ -C₆)alkyl;

G is selected from the group consisting of CH₂, nitrogen, oxygen, sulfur and carbonyl;

R²⁰ is monocyclic or bicyclic heterocycle selected from the group consisting of pyrimidinyl, benzoxazolyl, 2,3-dihydro-3-oxobenzisosulfonazol-2-yl, morpholin-1-yl, thiomorpholin-1-yl, benzofuranyl, benzothienyl, indolyl, isoindolyl, isoquinolinyl, furyl, pyridyl, isothiazolyl, oxazolyl, triazolyl, tetrazolyl, quinolyl, thiazolyl, thienyl, and groups of the formulae ##STR12## wherein B and D are selected form carbon, oxygen, and nitrogen, and at least one of B and D is other than carbon; E is carbon or nitrogen; n is an integer from 1 to 5; and any one of the carbons of the (CH₂)_(n) or (CH₂)_(n+1) may be optionally substituted with (C₁ -C₆)alkyl or (C₂ -C₆) spiroalkyl, and either any two of the carbon atoms of said (CH₂)_(n) and (CH₂)_(n+1) may be bridged by a one or two carbon atom linkage, or any one pair of adjacent carbons of said (CH₂)_(n) and (CH₂)_(n+1) may form, together with from one to three carbon atoms that are not members of the carbonyl containing ring, a (C₃ -C₅) fused carbocyclic ring;

with the proviso that (a) when m is 0, one of R¹⁶ and R¹⁷ is absent and the other is hydrogen, (b) when R³ is a group of the formula VIII, R¹⁴ and R¹⁵ cannot be attached to the same carbon atom, (c) when R¹⁴ and R¹⁵ are attached to the same carbon atom, then either each of R¹⁴ and R¹⁵ is independently selected from hydrogen, fluoro, (C₁ -C₆) alkyl, hydroxy-(C₁ -C₆)alkyl and (C₁ -C₆)alkoxy-(C₁ -C₆)alkyl, or R¹⁴ and R¹⁵, together with the carbon to which they are attached, form a (C₃ -C₆) saturated carbocyclic ring that forms a spiro compound with the nitrogen-containing ring to which they are attached; (d) R¹² and R¹³ cannot both be hydrogen; (e) when R¹⁴ or R¹⁵ is attached to a carbon atom of X⁴ or (CH₂)_(y) that is adjacent to the ring nitrogen then R¹⁴ or R¹⁵, respectively, must be a substituent wherein the point of attachment is a carbon atom; and (f) neither R¹⁴, R¹⁵, R¹⁶ nor R¹⁷ can form a ring with R¹³ ;

or a pharmaceutically acceptable salt thereof, effective in treating or preventing such condition.

The fused bicyclic nucleus of compounds of the formula Ib to which W and the --CN₂ NR² R³ sidechain are attached may be, but is not limited to one of the following groups: benzoxazolyl, benzthiazolyl, benzimidazolyl, benzisoxazolyl, benzoisothiazolyl, indazolyl, indolyl, isoquinolinyl, benzofuryl, benzothienyl, oxindolyl, benzoxazolinonyl, benzthiazolinonyl, benzimidazolinonyl, benzimidazoliniminyl, dihydrobenzothienyl-S,S-dioxide, benztriazolyl, benzthiadiazolyl, benzoxadiazolyl, and quinazolinyl.

Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraphs (1) through (46) below, that is effective in treating or preventing such condition.

(1) A compound of the formula Ia or Ib wherein the substituents at positions "2" and "3" of the nitrogen containing ring of R³ are in a cis configuration. (When R³ is a group of the formula VII or VIII, "a cis configuration", as used herein, means that the non-hydrogen substituent at position "3" is cis to R¹²).

(2) A compound of the formula Ia wherein R³ is a group of the formula III, VII or IX; R² is hydrogen; A is phenyl or indolinyl; W is (C₁ -C₃)alkoxy optionally substituted with from one to five fluorine atoms; and R is thiazolyl, imidazolyl, thiadiazolyl, pyrrolyl or oxazolyl, and R may optionally be substituted with one or two (C₁ -C₃) alkyl moieties.

(3) A compound of the formula Ib wherein R³ is a group of the formula III, VII or IX; R² is hydrogen; the fused bicyclic ring system to which W and the --CH₂ NR² R³ sidechain are attached is benzoxazolyl, benzisoxazolyl, benzthiazolyl or benzimidazolyl; and W is (C₁ -C₆)alkoxy optionally substituted with from one to five fluorine atoms.

(4) A compound as defined in paragraph 1, 2 or 3 above wherein: (a) R³ is a group of the formula III and R⁹ is benzhydryl; (b) R³ is a group of the formula VII, R¹² is phenyl, each of R¹³, R¹⁴, R¹⁵ and R¹⁶ is hydrogen, m is zero and X⁴ is --(CH₂)₃ --; or (c) R³ is a group of the formula IX, r is two and R¹⁹ is benzhydryl.

(5) A compound of the formula Ia wherein: (a) R³ is a group of the formula III wherein the substituents at positions "2" and "3" of the nitrogen containing ring are in the cis configuration, R⁹ is benzhydryl and A is phenyl; or (b) R³ is a group of the formula VII wherein R¹² and the substituent at position "3" of the nitrogen containing ring are in the cis configuration, A is phenyl, R¹² is phenyl, each of R², R¹³, R¹⁴, R¹⁵ and R¹⁶ is hydrogen, m is zero, W is methoxy or isopropoxy, X⁴ is --(CH₂)₃ -- and R is thiazolyl, imidazolyl, pyrrolyl, oxazolyl or thiadiazolyl.

(6) A compound of the formula Ib wherein R³ is a group of the formula IX wherein the substituents at positions "2" and "3" of the nitrogen containing ring are in the cis configuration, R¹⁹ is benzhydryl, r is two and the fused bicyclic ring system to which W and the --CH₂ NR² R³ sidechain are attached is benzisoxazolyl or benzthiazolyl.

(7) A compound of the formula Ib wherein R³ is a group of the formula IX, R¹⁹ is benzhydryl, the fused bicyclic ring system to which W and the --CH₂ NR² R³ sidechain are attached is benzisoxazolyl, and W is methoxy.

(8) A compound of the formula Ib wherein R³ is a group of the formula VII, R¹² is phenyl, each of R¹³, R¹⁴, R¹⁵ and R¹⁶ is hydrogen, m is zero, X⁴ is --(CH₂)₃ --, and the fused bicyclic ring system to which W and the --CH₂ NR² R³ sidechain are attached is benzothiazolyl, benzoxazolyl or benzimidazolyl.

(9) A compound of the formula Ia wherein R³ is a group of the formula VII, each of R¹³, R¹⁴, R¹⁵ and R¹⁶ is hydrogen, m is zero, X⁴ is --(CH₂)₃ --, A is phenyl, W is methoxy, and R is selected from thiazolyl, imidazolyl, thiadiazolyl and isoxazolyl.

(10) A compound of the formula Ia or Ib that is selected from:

(2S,3S)-3-[2-methoxy-5-(2-thiazolyl)benzyl]amino-2-phenylpiperidine;

(2S,3S)-3-[5-(2-imidazolyl)-2-methoxybenzyl]amino-2-phenylpiperidine;

(2S,3S)-3-[2-methoxy-5-(2-oxopyrrolidinyl)benzyl]amino-2-phenylpiperidine;

(2S,3S)-3-[2-methoxy-5-(4-methyl-2-thiazolyl)benzyl]-amino-2-phenylpiperidine;

(2S,3S)-3-[2-methoxy-5-(1,2,3-thiadiazol-4-yl)benzyl]-amino-2-phenylpiperidine;

(2S,3S)-(6-methoxy-2-methyl-benzothiazol-5-ylmethyl)-(2-phenylpiperidin-3-yl)amine;

(2S,3S)-[5-(2,5-dimethyl-pyrrol-1-yl)-2-methoxybenzyl]-(2-phenylpiperidin-3-yl)amine;

(2S,3S)-3-[2-methoxy-5-(5-oxazolyl)benzyl]amino-2-phenylpiperidine;

(2S,3S)-(6-methoxy-2-methyl-benzoxazol-5-ylmethyl)-(2-phenyl-piperidin-3-yl)-amine; and

(1SR,2SR,3SR,4RS)-3-[6-methoxy-3-methylbenzisoxazol-5-yl]methylamino-2-benzhydrylazanorbornane.

(11) A compound of the formula Ic, wherein R³ is a group of the formula II, III, VII or IX; R² is hydrogen; ring AA is phenyl or indolinyl; W¹ is (C₁ -C₃)alkoxy optionally substituted with from one to three fluorine atoms; and R¹ is S(O)_(v) --(C₁ -C₁₀)alkyl wherein v is zero, one or two, S(O)_(v) -aryl wherein v is zero, one or two, --O-aryl, ##STR13## wherein one or both of the alkyl moieties may optionally be substituted with from one to three fluorine atoms, --N(SO₂ -(C₁ -C₁₀) alkyl)₂ or ##STR14## wherein said aryl is phenyl or benzyl and may optionally be substituted with from one to three substituents independently selected from (C₁ -C₄)alkyl, (C₁ -C₄)alkoxy and halo.

(12) A compound as defined in paragraph 11 above, wherein R³ is a group of the formula II, o is two, and each R⁶ and R⁷ is phenyl.

(13) A compound as defined in paragraph 11 above, wherein R³ is a group of the formula VII, each of R¹³, R¹⁴, R¹⁵ and R¹⁶ is hydrogen, R¹² is phenyl, m is zero and X⁴ is --(CH₂)₃ --.

(14) A compound as defined in paragraph 11 above, wherein R³ is a group of the formula IX, R¹⁹ is benzhydryl and r is two.

(15) A compound as defined in paragraph 11 above, wherein R³ is a group of the formula III, R⁸ is other than hydrogen and R⁹ is benzyhydryl.

(16) A compound to the formula Ic wherein the substituents at positions "2" and "3" of the nitrogen containing ring are in the cis configuration.

(17) A compound of the formula Ic wherein R³ is a group of the formula II wherein the substituents at positions "2" and "3" of the nitrogen containing ring are in the cis configuration, o is two, each of R⁶ and R⁷ is phenyl and ring AA is phenyl or indolinyl.

(18) A compound of the formula Ic wherein R³ is a group of the formula III wherein the substituents at positions "2" and "3" of the nitrogen containing ring are in the cis configuration, R⁸ is other than hydrogen, R⁹ is benzhydryl and ring AA is phenyl.

(19) A compound of the formula Ic wherein R³ is a group of the formula VII wherein R¹² and the substituent at position "3" of the nitrogen containing ring are in the cis configuration, ring AA is phenyl, R¹² is phenyl, each of R², R¹³, R¹⁴, R¹⁵ and R¹⁶ is hydrogen, m is zero, X⁴ is --(CH₂)₂ -- or --(CH₂)₃ -- and R¹ is selected from S(O)_(v) --(C₁ -C₁₀)alkyl wherein v is zero, one or two, and ##STR15## and di-(C₁ -C₆) alkylamino.

(20) A compound as defined in paragraph 19 above, wherein X⁴ is --(CH₂)₂ -- and W¹ is (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms.

(21) A compound as defined in paragraph 19 above, wherein X⁴ is --(CH₂)₃ -- and W¹ is (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms.

(22) A compound of the formula Ic, wherein R³ is a group of the formula IX wherein the substituents at positions "2" and "3" of the nitrogen containing ring are in the cis configuration, r is two and R¹⁹ is benzhydryl.

(23) A compound as defined in paragraph 22 above, wherein ring AA is phenyl, W^(l) is (C₁ -C₅) alkoxy optionally substituted with from one to three fluorine atoms and R¹ is selected from --S(O)_(v) --(C₁ -C₁₀)alkyl wherein v is zero, one or two, di-(C₁ -C₆)alkylamino and ##STR16##

(24) A compound as defined in paragraph 15 above, wherein ring AA is phenyl, W¹ is (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, and R¹ is selected from --S(O)_(v) --(C₁ -C₁₀)alkyl wherein v is zero, one or two, and ##STR17##

(25) A compound as defined in paragraph 15 above, wherein ring AA is phenyl, W¹ is (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, and R¹ is selected from amino, (C₁ -C₆) alkylamino or di-(C₁ -C₆)alkylamino.

(26) A compound as defined in paragraph 12 above, wherein ring AA is phenyl, W¹ is (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, and R¹ is selected from --S(O)_(v) --(C₁ -C₁₀)alkyl wherein v is zero, one or two, and ##STR18##

(27) A compound as defined in paragraph 12 above, wherein ring AA is phenyl, W¹ is (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, and R¹ is selected from amino, (C₁ -C₆)alkylamino or di-(C₁ -C₆)alkylamino.

(28) A compound as defined in paragraph 24 above, wherein W¹ is attached at the "2" position of ring AA and R¹ is attached at the "5" position of ring AA, relative to the point of attachment of the NR² R³ containing side chain.

(29) A compound as defined in paragraph 25 above, wherein W¹ is attached at the "2" position of ring AA and R¹ is attached at the "5" position of ring AA, relative to the point of attachment of the NR² R³ containing side chain.

(30) A compound as defined in paragraph 26 above, wherein W¹ is attached at the "2" position of ring AA and R¹ is attached at the "5" position of ring AA, relative to the point of attachment of the NR² R³ containing side chain.

(31) A compound as defined in paragraph 27 above, wherein W¹ is attached at the "2" position of ring AA and R¹ is attached at the "5" position of ring AA, relative to the point of attachment of the NR² R³ containing side chain.

(32) A compound as defined in paragraph 13 above, wherein ring AA is phenyl, W¹ is selected from isopropoxy, OCF₃, OCH₃, OCHF₂ and OCH₂ CF₃, and R¹ is selected from --S(O)_(v) -(C₁ -C₁₀)alkyl wherein v is zero, one or two, and (C₁ -C₁₀)alkyl-N-SO₂ -(C₁ -C₁₀)alkyl.

(33) A compound selected from the group consisting of:

(2S,3S)-N-(2-methoxy-5-methylsulfonylphenyl)-methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(2-methoxy-5-methylthiophenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(2-methoxy-5-dimethylaminophenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine; and

(2S,3S)-N-(5-trifluoroacetylamino-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo-[2.2.2]octan-3-amine.

(34) A compound of the formula Ic, wherein R³ is a group of the formula VII, m is zero, each of R¹³, R¹⁵, R¹⁶ and R¹⁷ is hydrogen, R¹² is phenyl ##STR19## ring AA is phenyl, W¹ is (C₁ -C₃)alkoxy and R¹ is selected from (C₁ -C₅)alkyl, --SCH₃, SO₂ CH₃, SOCH₃, (C₁ -C₆)alkylamino and di-(C₁ -C₆)alkyl-amino.

(35) A compound of the formula Ic, having the formula ##STR20##

(36) A compound of the formula Id wherein R⁶, R¹⁰, R¹¹ and R¹³ are phenyl, R⁸ is hydrogen, R⁹ is phenyl optionally substituted with chlorine, fluorine, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms or (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms, m is 0 and n is 3 or 4.

(37) A compound of the formula Id that is selected from the group consisting of:

(2S,3S)-3-(5-tert-butyl-2-methoxybenzyl)amino-2-(3-trifluoromethoxyphenyl)piperidine;

(2S,3S)-3-(2-isopropoxy-5-trifluoromethoxybenzyl)amino-2-phenyl-piperidine;

(2S,3S)-3-(2-ethoxy-5-trifluoromethoxybenzyl)amino-2-phenyl-piperidine;

(2S,3S)-3-(2-methoxy-5-trifluoromethoxybenzyl)-amino-2-phenylpiperidine;

(2S,3S)-3(-5-tert-butyl-2-trifluoromethoxybenzyl)amino-2-phenylpiperidine;

2-(diphenylmethyl)-N-(2-methoxy-5-trifluoromethoxyphenyl)methyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-3-[5-chloro-2-(2,2,2-trifluoroethoxy)benzyl]amino-2-phenylpiperidine;

(2S,3S)-3-(5-tert-butyl-2-trifluoromethoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(2-isopropoxy-5-trifluoromethoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(2-difluoromethoxy-5-trifluoromethoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-2-phenyl-3-[2-(2,2,2-trifluoroethoxybenzyl)aminopiperidine; and

(2S,3S)-2-phenyl-3-(2-trifluoromethoxybenzyl)]aminopiperidine.

(38) A compound of the formula Id, wherein R³ is a group of the formula II wherein o is two or three and each of R⁶ and R⁷ is phenyl or substituted phenyl.

(39) A compound of the formula Id, wherein R³ is a group of the formula III, R⁸ is hydrogen and R⁹ is phenyl or substituted phenyl.

(40) A compound of the formula Id, wherein R³ is a group of the formula IV wherein l is one or two and each of R¹⁰ and R¹¹ is phenyl or substituted phenyl.

(41) A compound of the formula Id, wherein R³ is a group of the formula V wherein n is zero or one and each of R¹⁰ and R¹¹ is phenyl or substituted phenyl.

(42) A compound of the formula Id, wherein R³ is a group of the formula VI wherein p is one and each of R¹⁰ and R¹¹ are phenyl or substituted phenyl.

(43) A compound of the formula Id, wherein R³ is a group of the formula VII wherein q is two, three or four, m is zero and R¹² is phenyl or substituted phenyl.

(44) A compound of the formula Id, wherein R³ is a group of the formula VIII wherein y is zero, x is zero or one, z is three or four, m is zero and R¹² is phenyl or substituted phenyl.

(45) A compound of the formula Id wherein R³ is a group of the formula VII, R⁶, R¹⁴, R¹³ R¹⁶ and R¹⁵ are hydrogen, R¹² is phenyl, X¹ is 2-methoxy, X² and X³ are independently selected from hydrogen, chlorine, fluorine, methyl, (C₁ -C₆)alkoxy and trifluoromethane, m is 0 and q is 3 or 4.

(46) A compound of the formula Id wherein R³ is a group of the formula VII and said compound is selected from the group consisting of:

cis-3-(2-chlorobenzylamino)-2-phenylpiperidine;

cis-3-(2-trifluoromethylbenzylamino)-2-phenylpiperidine;

cis-3-(2-methoxybenzylamino)-2-(2-fluorophenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(2-chlorophenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(2-methylphenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(3-methoxyphenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(3-fluorophenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(3-chlorophenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-phenylpiperidine;

cis-3-(2-methoxybenzylamino)-2-(3-methylphenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(4-fluorophenyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-(3-thienyl)-piperidine;

cis-3-(2-methoxybenzylamino)-2-phenylazacyclo-heptane;

3-(2-methoxybenzylamino)-4-methyl-2-phenyl-piperidine;

3-(2-methoxybenzylamino)-5-methyl-2-phenyl-piperidine;

3-(2-methoxybenzylamino)-6-methyl-2-phenyl-piperidine;

(2S,3S)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(5-carboethoxypent-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(6-hydroxy-hex-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(4-hydroxy-4-phenylbut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(4-oxo-4-phenylbut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(5,6-dihydroxyhex-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

cis-3-(5-fluoro-2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-[4-(4-fluorophenyl)-4-oxobut-1-yl]-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-[4-(4-fluorophenyl)-4-hydroxybut-1-yl]-3-(2-methoxybenzylamino)-2-phenylpiperidine;

cis-3-(2-methoxy-5-methylbenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(4-benzamidobut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

cis-3-(2-methoxynaphth-1-ylmethylamino)-2-phenylpiperidine;

(2S, 3S)-3-(2-methoxybenzylamino)-1-(5-N-methylcarboxamidopent-1-yl)-2-phenylpiperidine;

(2S,3S)-1-(4-cyanobut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-[4-(2-naphthamido)but-1-yl]-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(5-benzamidopent-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-1-(5-aminopent-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-3-(5-chloro-2-methoxybenzylamino)-2-phenylpiperidine;

(2S,3S)-3-(2,5-dimethoxybenzylamino)-2-phenylpiperidine;

cis-3-(3,5-difluoro-2-methoxybenzylamino)-2-phenylpiperidine;

cis-3-(4,5-difluoro-2-methoxybenzylamino)-2-phenylpiperidine;

cis-3-(2,5-dimethoxybenzylamino)-1-[4-(4-fluorophenyl)4-oxobut-1-yl]-2-phenylpiperidine;

cis-3-(5-chloro-2-methoxybenzylamino)-1-(5,6-dihydroxyhex-1-yl)-2-phenylpiperidine;

cis-1-(5,6-dihydroxyhex-1-yl)-3-(2,5-dimethoxybenzylamino)-2-phenylpiperidine;

cis-2-phenyl-3-[-2(prop-2-yloxy)benzylamino]piperidine;

cis-3-(2,5-dimethoxybenzyl)amino-2-(3-methoxyphenyl)piperidine hydrochloride;

cis-3-(5-chloro-2-methoxybenzyl)amino-2-(3-methoxyphenyl)piperidine dihydrochloride;

cis-3-(5-chloro-2-methoxybenzyl)amino-2-(3-chlorophenyl)piperidine dihydrochloride;

3-(2-methoxybenzylamino)-2,4-diphenylpiperidine;

cis-3-(2-methoxybenzylamino)-2-phenylpyrrolidine;

(2S,3S)-3-(5-ethyl-2-methoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(5-n-butyl-2-methoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(2-methoxy-5-n-propylbenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(5-isopropyl-2-methoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(5-s-butyl-2-methoxybenzyl)amino-2-phenylpiperidine;

(2S,3S)-3-(5-t-butyl-2-methoxybenzyl)amino-2-phenylpiperidine; and

(2S,3S)-3-(2-methoxy-5-phenylbenzyl)amino-2-phenylpiperidine.

(47) A compound of the formula Id, wherein R³ is a group of the formula II or III and said compound is selected from the group consisting of:

(2S,3S)-N-(5-isopropyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(5-tert-butyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(5-methyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(5-ethyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(5-isopropyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine;

(2S,3S)-N-(5-sec-butyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine; and

(2S,3S)-N-(5-n-propyl-2-methoxyphenyl)methyl-2-diphenylmethyl-1-azabicyclo[2.2.2]octan-3-amine.

This invention also relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal an amount of a compound having the formula ##STR21## wherein W is Y or X(CH₂)_(n) ;

Y is optionally substituted (C₁ -C₆)alkyl, optionally substituted (C₂ -C₆)alkenyl or optionally substituted (C₃ -C₈)cycloalkyl;

X is optionally substituted (C₁ -C₆)alkoxy, CONR¹ R², CO₂ R¹, CHR¹ OR², CHR¹ NR² R³, COR¹, CONR¹ OR² or optionally substituted aryl, wherein said aryl is selected from phenyl, naphthyl, pyridyl, quinolyl, thienyl, furyl, phenoxyphenyl, oxazolyl, tetrazolyl, thiazolyl, imidazolyl and pyrazolyl; and n is an integer from zero to six;

Ar¹, Ar² and Ar³ are each, independently, optionally substituted aryl, wherein said aryl is selected from phenyl, naphthyl, pyridyl, quinolyl, thienyl, furyl, phenoxyphenyl, oxazolyl, tetrazolyl, thiazolyl, imidazolyl and pyrazolyl;

and R¹, R² and R³ are independently selected from hydrogen, optionally substituted (C₁ -C₆)alkyl, optionally substituted (C₁ -C₆)alkoxy, optionally substituted (C₃ -C₈)cycloalkyl, optionally substituted aryl, wherein said aryl is selected from phenyl, naphthyl, pyridyl, quinolyl, thienyl, furyl, phenoxyphenyl, oxazolyl, tetrazolyl, thiazolyl, imidazolyl and pyrazolyl; and optionally substituted (C₁ -C₅)heterocyclic groups, wherein said heterocyclic groups are selected from pyrrolidino, piperidino, morpholino, piperazinyl and thiamorpholino;

and wherein the substituents on the foregoing substituted alkyl, alkenyl, cycloalkyl and alkoxy groups are independently selected from halo, nitro, amino, (C₁ -C₄)alkyl, (C₁ -C₄)alkoxy, trifluoromethyl and trifluoromethoxy;

and wherein the substituents on the foregoing substituted heterocyclic groups are attached to an oxygen or nitrogen atom on the ring and are independently selected from oxygen and (C₁ -C₄)alkyl;

and wherein the substituents on said substituted Ar¹ groups are independently selected from (C₁ -C₆)alkyl optionally substituted with from one to three halo groups, (C₁ -C₆)alkoxy optionally substituted with from one to three halo groups, (C₁ -C₆)alkylsulfinyl, (C₂ -C₆)alkenyl, (C₁ -C₆)alkylthio, (C₁ -C₆)alkylsulfonyl, (C₁ -C₆)alkylsulfonylamino, and di-(C₁ -C₆)alkylamino wherein one or both of the alkyl groups may be optionally substituted with a (C₁ -C₆)alkylsulfonyl or (C₁ -C₆)alkylsulfinyl group;

and wherein the substituents on said substituted Ar² and Ar³ groups are independently selected from (C₁ -C₄)alkyl, (C₁ -C₄)alkoxy, (C₁ -C₄)alkylthio, (C₁ -C₄)alkylsulfinyl, di-(C₁ -C₄)alkylamino, trifluoromethyl and trifluoromethoxy;

and wherein the substituents on said substituted (C₁ -C₅) heterocyclic groups are independently selected from oxygen and (C₁ -C₄)alkyl; or a pharmaceutically acceptable salt of such compound, effective in treating or preventing such condition.

Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraphs (48) through (53) below, that is effective in treating or preventing such condition.

(48) A compound of the formula X, wherein W is X(CH₂)_(n).

(49) A compound of the formula X, wherein W is Y.

(50) A compound of the formula X, wherein Ar¹ is substituted aryl and W is Y.

(51) A compound of the formula X, wherein Ar¹ is mono-, di- or tri-substituted phenyl and W is Y.

(52) A compound of the formula X, wherein Ar¹ is phenyl disubstituted at the 2- and 5-positions and W is Y.

(53) A compound of the formula X, wherein Ar¹ is paramethoxyphenyl, each of Ar² and Ar³ is phenyl and W is Y.

(54) A compound of the formula X that is selected from the group consisting of:

(3R,4S,5S,6S)-N,N-diethyl-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide;

(3R,4S,5S,6S)-N,N-diethyl-5-(2,5-dimethoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide;

(3R,4S,5S,6S)-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-2-methylthiobenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2,5-dimethoxybenzylamino)-6-diphenylmethyl-1-azabicyclo-[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(5-ethyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxyl-5-n-propylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(5-sec-butyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(5-aminosulfonylmethyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylsulfinylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-trifluoromethoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylsulfonylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(5-dimethylamino-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxylic acid;

(3R,4S,5S,6S)-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylthiobenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2,5-dimethoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(5-ethyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxyl-5-n-propylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(5-sec-butyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(5-aminosulfonylmethyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylsulfinylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-trifluoromethoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid;

(3R,4S,5S,6S)-5-(2-methoxy-5-methylsulfonylbenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid; and

(3R,4S,5S,6S)-5-(5-dimethylamino-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-2-carboxylic acid.

This invention also relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal an amount of a compound having the formula ##STR22## wherein R¹ is selected from hydrogen, (C₁ -C₆) straight or branched alkyl, (C₃ -C₇) cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from phenyl, biphenyl, indanyl and naphthyl; heteroaryl selected from thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl (C₂ -C₆) alkyl, benzhydryl and benzyl, wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl (C₂ -C₆) alkyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆) alkoxy, amino, trihaloalkoxy (e.g., trifluoromethoxy), ##STR23## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl;

R³ is aryl selected from phenyl and naphthyl; heteroaryl selected from indanyl, thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; and cycloalkyl having 3 to 7 carbon atoms wherein one of said carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; wherein each of said aryl and heteroaryl groups may optionally be substituted with one or more substituents, and said (C₃ -C₇) cycloalkyl may optionally be substituted with one or two substituents, each of said substituents being independently selected from halo, nitro, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms, amino, phenyl, trihaloalkoxy (e.g., trifluoromethoxy), ##STR24##

one of R⁵ and R⁶ is hydrogen and the other is selected from hydroxymethyl, hydrogen, (C₁ -C₃)alkyl, (C₁ -C₈)acyloxy-(C₁ -C₃)alkyl, (C₁ -C₈)alkoxymethyl and benzyloxymethyl;

R⁷ and R⁸ are independently selected from hydrogen, (C₁ -C₃)alkyl and phenyl;

R⁹ is selected from methyl, hydroxymethyl, ##STR25## R¹⁴ R¹⁵ NCO₂ CH₂ --, R¹⁶ OCO₂ CH₂ --, (C₁ -C₄)alkyl--CO₂ CH₂ --, --CONR¹⁷ R¹⁸, R¹⁷ R¹⁸ NCO₂ --, R¹⁹ OCO₂ --, C₆ H₅ CH₂ CO₂ CH₂ --, C₆ H₅ CO₂ CH₂ --, (C₁ -C₄)alkyl-CH(OH)--, C₆ H₅ CH(OH)--, C₆ H₅ CH₂ CH(OH)--, CH₂ halo, R²⁰ SO₂ OCH₂, --CO₂ R¹⁶ and R²¹ CO₂ --;

R¹⁰ and R¹¹ are independently selected from hydrogen, (C₁ -C₃) alkyl and phenyl;

R¹² is hydrogen, benzyl or a group of the formula ##STR26## wherein m is an integer from zero to twelve, and any one of the carbon-carbon single bonds of (CH₂)_(m), wherein both carbon atoms of such bond are bonded to each other and to another carbon atom in the (CH₂)_(m) chain, may optionally be replaced by a carbon-carbon double or triple bond, and any one of the carbon atoms of (CH₂)_(m) may optionally be substituted with R²³ ;

R¹³ R¹⁴, R¹⁵, R¹⁶, R¹⁷, R¹⁸, R¹⁹, R²⁰, R²¹ and R²⁴ are independently selected from hydrogen, (C₁ -C₃)alkyl and phenyl;

R²² and R²³ are independently selected from hydrogen, hydroxy, halo, amino, carboxy, carboxy(C₁ -C₆)alkyl, (C₁ -C₆)alkylamino, di-(C₁ -C₆)alkylamino, (C₁ -C₆)alkoxy, ##STR27## (C₁ -C₆) straight or branched alkyl, (C₃ -C₇) cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from phenyl and naphthyl; heteroaryl selected from indanyl, thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl-(C₂ - C₆)alkyl, benzhydryl and benzyl, wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl-(C₂ -C₆)alkyl and benzhydryl may optionally be substituted with one or two substituents independently selected from halo, nitro, (C₁ -C₆)alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, trifluoromethyl, amino, (C₁ -C₆)-alkylamino, ##STR28## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl;

or R⁹, together with the carbon to which it is attached, the nitrogen of the pyrrolidine ring, the carbon to which R⁷ is attached and the carbon to which R⁵ and R⁶ are attached form a second pyrrolidine ring; with the proviso that when R⁹, together with the carbon to which it is attached, the nitrogen of the pyrrolidine ring, the carbon to which R⁷ is attached and the carbon to which R⁵ and R⁶ are attached, form a second pyrrolidine ring (thus forming a bicyclic structure containing a bridgehead nitrogen), either R¹² is absent or R¹² is present and the nitrogen of the second pyrrolidine ring is positively charged; or a pharmaceutically acceptable salt of such compound, effective in treating or preventing such condition. Compounds of the formula XI that contain two pyrrolidine rings may be represented by one of the following two structures, depending on whether R¹² is present or absent. ##STR29## Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraphs (55) through (59) below, that is effective in treating or preventing such condition.

(55) A compound of the formula XI wherein R¹ is benzhydryl.

(56) A compound of the formula XI wherein R¹ is diphenylmethyl, R³ is aryl selected from phenyl or indanyl wherein each of said aryl groups may be optionally substituted with one, two or three substituents, each of R⁵, R⁶, R⁷, R⁸, R¹⁰, and R¹¹ is hydrogen, R⁹ is selected from hydroxymethyl, methoxymethyl, --CO₂ R¹⁶, --CONR¹⁷ R¹⁸, R¹⁴ R¹⁵ NCO₂ CH₂ --, R¹⁶ OCO₂ CH₂ --, (C₁ C₄)alkyl-CO₂ CH₂ --, C₆ H₅ CH₂ CO₂ CH₂ --, --CH₂ halo and R²⁰ SO₂ OCH₂ --, and R¹² is hydrogen or benzyl.

(57) A compound of the formula XI wherein R¹ is phenyl, R³ is aryl selected from phenyl or indanyl wherein each of said aryl groups may be optionally substituted with one, two or three substituents, each of R⁵, R⁶, R⁷, R⁸, R¹⁰, and R¹¹ is hydrogen, R⁹ is selected from hydroxymethyl, methoxymethyl, --CO₂ R¹⁸, --CONR¹⁷ R¹⁸, R¹⁴ R¹⁵ NCO₂ CH₂ CH₂ --, R¹⁶ OCO₂ CH₂ --, (C₁ -C₄)alkyl-CO₂ CH₂ --, --CH₂ halo, R²⁰ SO₂ OCH--, and R¹² is hydrogen or benzyl.

(58) A compound of the formula XI wherein R¹ is diphenylmethyl, R³ is aryl selected from phenyl or indanyl wherein each of said aryl groups may be optionally substituted with one, two or three substituents, each of R⁵, R⁶, R⁷, R⁸, R¹⁰, R¹¹ and R¹³ is hydrogen, and wherein R⁹, together with the carbon to which it is attached, the nitrogen of the pyrrolidine ring, the carbon to which R⁷ is attached and the carbon to which R⁵ and R⁶ are attached, form a second pyrrolidine ring (thus forming a bicyclic structure containing a bridgehead nitrogen).

(59) A compound of the formula XI that is selected from the group consisting of:

(2S,3S,4R)-2-diphenylmethyl-3-[(2-methoxy-4,5-dimethylphenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-4,5-dimethylphenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(methylethyl)phenyl)methylamino]-4-(carbomethoxymethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(methylethyl)phenyl)methylamino]-4-(carboxymethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(methylethyl)phenyl)methylamino]-4-(2-dimethylaminocarbamoylethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-trifluoromethoxyphenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2S,3S,4R)-2-diphenylmethyl-3-[(2-methoxy-5-(1,1-dimethylethyl)phenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(1,1-dimethylethyl)phenyl)methylamino]-4-(2-methoxyethyl)-pyrrolidine;

(2S,3S,4R)-2-diphenylmethyl-3-[(2-methoxy-5-methylethyl)phenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-methylethyl)phenyl)methylamino]-4-(2-methoxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methyl-5-(1,1-dimethylethyl)phenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxy-4,5-dimethylphenyl)-methylamino]-bicyclo[2.2.1]-heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxyphenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxy-5-(1,1-dimethylethyl)phenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxy-5-trifluoromethoxyphenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxy-5-(1-methylethyl)phenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxy-5-propylphenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-diphenylmethyl-3-[(2-methoxy-5-(1-methylpropyl)phenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3SR,4RS)-1-aza-2-phenyl-3-[(2-methoxyphenyl)methylamino]bicyclo[2.2.1]heptane;

(1SR,2SR,3RS,4RS)-1-aza-2-phenyl-3-[(2-methoxy-5-trifluoromethoxyphenyl)methylamino]bicyclo[2.2.1]heptane;

(2SR,3SR,4RS)-N-1-phenylmethyl-2-diphenylmethyl-3-[(2-methoxyphenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxyphenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(1,1-dimethylethyl)phenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-trifluoromethoxyphenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(1-methylethyl)phenyl)methylamino]-4-(2-hydroxyethyl)-pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-propylphenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-(1-methyl-1-propyl)phenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-trifluoromethoxy-5-(1,1-dimethylethyl)phenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-diphenylmethyl-3-[(2-methoxy-5-chlorophenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-phenyl-3-[(2-methoxyphenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine;

(2SR,3SR,4RS)-2-phenyl-3-[(2-methoxy-5-(1,1-dimethylethyl)phenyl)methylamino]-4-(2 -hydroxyethyl)pyrrolidine; and

(2SR,3SR,4RS)-2-phenyl-3-[(2-methoxy-5-trifluoromethoxyphenyl)methylamino]-4-(2-hydroxyethyl)pyrrolidine.

This invention also relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal an amount of a compound of the formula ##STR30## wherein R¹ is hydrogen, (C₁ -C₈) alkyl, a saturated (C₆ -C₁₀) carbocyclic ring system containing two fused rings, a saturated (C₆ -C₁₀) carbocyclic bridged ring system containing two rings, or benzyl wherein the phenyl moiety of said benzyl may optionally be substituted with one or more substituents independently selected from halo, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms and (C₁ -C₈) alkoxy optionally substituted with from one to three fluorine atoms;

R² is hydrogen, benzyl or a group of the formula ##STR31## wherein m is an integer from zero to twelve, and any one of the carbon-carbon single bonds of (CH₂)_(m), wherein both carbon atoms of such bond are bonded to each other and to another carbon atom of the (CH₂)_(m) chain, may optionally be replaced by a carbon-carbon double or triple bond, and any one of the carbon atoms of (CH₂)_(m) may optionally be substituted with R⁹ ;

R⁸ and R⁹ are independently selected from hydrogen, hydroxy, halo, amino, carboxy, carboxy(C₁ -C₆)alkyl, (C₁ -C₆)alkylamino, di-(C₁ -C₆)alkylamino, (C₁ -C₆)alkoxy, ##STR32## (C₁ -C₆) straight or branched alkyl, (C₃ -C₇) cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from phenyl and naphthyl; heteroaryl selected from indanyl, thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl-(C₂ -C₆) alkyl, benzhydryl and benzyl, wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl-(C₂ -C₆)alkyl and benzhydryl may optionally be substituted with one or two substituents independently selected from halo, nitro, (C₁ -C₆)alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, trifluoromethyl, amino, ##STR33## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl;

or R¹ and R², together with the nitrogen to which they are attached, form a saturated or unsaturated monocyclic ring containing from three to eight carbon atoms, a fused bicyclic ring containing from six to ten carbon atoms, or a saturated bridged ring system containing from six to ten carbon atoms;

R⁴ is aryl selected from phenyl and naphthyl; heteroaryl selected from indanyl, thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; and cycloalkyl having from three to seven carbon atoms wherein one of said carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; wherein each of said aryl and heteroaryl groups may optionally be substituted with one or more substituents, and said (C₃ -C₇) cycloalkyl may optionally be substituted with one, two or three substituents, each of said substituents being independently selected from halo, nitro, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆) alkoxy optionally substituted with from one to three fluorine atoms, phenyl, amino, ##STR34##

R³ is hydrogen, (C₃ -C₈)cycloalkyl, (C₁ -C₆) straight or branched alkyl or phenyl optionally substituted with one or more substituents independently selected from halo, (C₁ - C₆) alkyl optionally substituted with from one to three fluorine atoms, and (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms;

R⁵ is hydrogen, (C₁ -C₆)alkyl, or phenyl optionally substituted with one or more substituents independently selected from halo, (C₁ -C₆)alkyl optionally substituted with from one to three fluorine atoms and (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms;

R⁶ is selected from hydrogen, (C₁ -C₆) straight or branched alkyl, (C₃ -C₇) cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from phenyl, biphenyl, indanyl and naphthyl; heteroaryl selected from thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl (C₂ -C₆) alkyl, benzhydryl and benzyl, wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl (C₂ -C₆) alkyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆) alkoxy, trifluoromethyl, amino, trihaloalkoxy (e.g., trifluoromethoxy), (C₁ -C₆)alkylamino, ##STR35## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl; and

R¹² is hydrogen, (C₁ -C₃)alkyl or phenyl;

or a pharmaceutically acceptable salt of such compound, that is effective in treating or preventing such condition.

Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraphs (60) through (62) below, that is effective in treating or preventing such condition.

(60) A compound of the formula XII wherein R² is hydrogen or R² and R¹, together with the nitrogen to which they are attached, form a monocyclic ring containing five to seven carbon atoms; R³ is hydrogen, methyl or phenyl; R⁵ is hydrogen; R⁴ is phenyl or indanyl, wherein said phenyl or indanyl may optionally be substituted with from one to three substituents independently selected from halo, nitro, (C₁ -C₆) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆) alkoxy, trihaloalkoxy (e.g., trifluoromethoxy), (C₁ -C₆) alkylamino, --C(O)NH--(C₁ -C₈)alkyl, (C₁ -C₆)alkyl--C(O)--, --C(O)--O--(C₁ -C₆)alkyl, --C(O)H, --CH₂ OR¹², --NH(C₁ -C₆)alkyl, --NHC(O)H, --NHC(O)--(C₁ -C₆)alkyl, --NHSO₂ (C₁ -C₆)alkyl and (C₁ -C₆)alkyl--N--SO₂ --(C₁ -C₆)alkyl; and R⁶ is phenyl.

(61) A compound of the formula XII wherein R¹ is alkyl, R⁶ is unsubstituted phenyl, R⁴ is a monosubstituted or disubstituted aryl group that is substituted at the C-2 position with an alkoxy group or substituted at the C-5 position with an alkyl, alkoxy or trihaloalkoxy group, or substituted in such manner at both C-2 and C-5 positions (i.e., with an alkoxy group at the C-2 position and an alkyl, alkoxy or trihaloalkoxy group at the C-5 position), and each of R², R³ and R⁵ is hydrogen.

(62) A compound of the formula XII that is selected from the group consisting of:

1-N-cyclohexyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-cyclohexyl-1-phenyl-2-N'-[(2-methoxy-5-trifluoromethoxyphenyl)methyl]-1,2-ethanediamine;

1-N-pyrrolidyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-methyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-cyclopentyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-propyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-phenylmethyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-cyclooctyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-cyclobutyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-(2-adamantyl)-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-(1,1-dimethylethyl) -1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-cyclopropyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-isopropyl-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-(1-phenylethyl)-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-(2-norbornyl)-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine;

1-N-cyclohexyl-1-phenyl-2-N'-[(2-methoxy-5-tert-butylphenyl)methyl]-1,2-ethanediamine;

1-N-cyclohexyl-1-phenyl-2-N'-[(2-methoxy-5isopropylphenyl)methyl]-1,2-ethanediamine;

1-N-cyclohexyl-1-phenyl-2-N'-[(2-methoxy-4,5-dimethylphenyl)methyl]-1,2-ethanediamine; and

1-N-cyclohexyl-1-N-(6-hydroxyhexyl)-1-phenyl-2-N'-[(2-methoxyphenyl)methyl]-1,2-ethanediamine.

This invention also relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal an amount of a compound of the formula ##STR36## wherein R¹ is cycloalkyl having from five to seven carbon atoms, pyrrolyl, thienyl, pyridyl, phenyl or substituted phenyl, wherein said substituted phenyl is substituted with from one to three substituents independently selected from fluorine, chlorine, bromine, trifluoromethyl, alkyl having from one to three carbon atoms, alkoxy having from one to three carbon atoms, carboxy, alkoxycarbonyl having from one to three carbon atoms in the alkoxy moiety and benzyloxycarbonyl;

R² is furyl, thienyl, pyridyl, indolyl, biphenyl, phenyl or substituted phenyl, wherein said substituted phenyl is substituted with one or two substituents independently selected from fluorine, chlorine, bromine, trifluoromethyl, alkyl having from one to three carbon atoms, alkoxy having from one to three carbon atoms, carboxy, alkoxycarbonyl having from one to three carbon atoms in the alkoxy moiety and benzyloxycarbonyl; and

R³ is thienyl, phenyl, fluorophenyl, chlorophenyl or bromophenyl, or a pharmaceutically acceptable salt of such compound, effective in treating or preventing such condition.

Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraphs (63) through (65) below, that is effective in treating or preventing such condition.

(63) A compound of the formula XIII, wherein R¹ is phenyl or substituted phenyl.

(64) A compound of the formula XIII, wherein R¹ is methoxyphenyl.

(65) A compound of the formula XIII, wherein said compound is (±)-cis-9-diphenylmethyl-N-((2-methoxyphenyl)methyl)-10-azatricyclo[4.4.1.0⁵,7 ]undecan-8-amine.

This invention also relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal an amount of a compound of the formula ##STR37## wherein m is an integer from 0 to 8, and any one of the carbon-carbon single bonds of (CH₂)_(m), wherein both carbon atoms of such bond are bonded to each other and to another carbon atom in the (CH₂)_(m) chain, may optionally be replaced by a carbon-carbon double bond or a carbon-carbon triple bond, and any one of the carbon atoms of said (CH₂)_(m) may optionally be substituted with R⁸ ;

w is an integer from 0 to 2;

y is an integer from 1 to 4;

z is an integer from 1 to 4, and wherein any one of the carbon atoms of said (CH₂)_(z) may optionally be substituted with R⁴ ;

R¹ is hydrogen or (C₁ -C₈) alkyl optionally substituted with hydroxy, alkoxy or fluoro;

R² is a group selected from hydrogen, (C₁ -C₆)straight or branched alkyl, (C₃ -C₇)cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from phenyl, indanyl, and naphthyl; heteroaryl selected from thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl (C₂ -C₆)alkyl, benzhydryl and benzyl, wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl and wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl(C₂ -C₆)alkyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₆)alkyl, (C₁ -C₆)alkoxy, trifluoromethyl, amino, ##STR38##

R⁵ is hydrogen, phenyl or (C₁ -C₆)alkyl;

or R² and R⁵, together with the carbon to which they are attached, form a saturated carbocyclic ring having from 3 to 7 carbon atoms wherein one of said carbon atoms may optionally be replaced by oxygen, nitrogen or sulfur;

R³ is aryl selected from phenyl, indanyl and naphthyl; heteroaryl selected from thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; and cycloalkyl having 3 to 7 carbon atoms wherein one of said carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; wherein each of said aryl and heteroaryl groups may optionally be substituted with one or more substituents, and said (C₃ -C₇) cycloalkyl may optionally be substituted with one or two substituents, each of said substituents being independently selected from halo, nitro, (C₁ -C₆)alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₆)alkoxy optionally substituted with from one to three fluorine atoms, trifluoromethyl, phenyl, ##STR39##

R⁴ is independently selected from hydrogen, hydroxy, halo, amino, oxo (═O) , nitrile, (C₁ -C₆)alkylamino, di-(C₁ -C₆)alkylamino, (C₁ -C₆)alkoxy, ##STR40## and the groups set forth in the definition of R² ; ##STR41## NHCH₂ R⁹, NHSO₂ R⁹ or one of the groups set forth in any of the definitions of R², and R⁴ ;

R⁸ is oximino (═NOH) or one of the groups set forth in any of the definitions of R², and R⁴ ;

R⁹ is (C₁ -C₆)alkyl, hydrogen, phenyl or phenyl (C₁ -C₆) alkyl;

with the proviso that (a) when m is 0, R⁸ is absent and R⁶ is hydrogen, (b) neither R⁴, R⁶, nor R⁸ can form, together with the carbon to which it is attached, a ring with R⁵, (c) the sum of y and z must be less than 7; or a pharmaceutically acceptable salt thereof, effective in treating or preventing such condition.

Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraphs (66) through (68) below, that is effective in treating or preventing such condition.

(66) A compound of the formula XIV, wherein R² is a radical selected from hydrogen, phenyl, naphthyl and benzhydryl; wherein each of said phenyl, naphthyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₆) alkyl, (C₁ -C₆)alkoxy, trifluoromethyl, amino, ##STR42## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl.

(67) A compound of the formula XIV, wherein R² is a group selected from hydrogen, phenyl, naphthyl and benzhydryl; wherein each of said phenyl, naphthyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₆) alkyl, (C₁ -C₆) alkoxy, trifluoromethyl, amino, ##STR43## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl; and

R⁴ is independently selected from hydrogen, hydroxy, halo, amino, oxo (═O), nitrile, (C₁ -C₆)alkylamino, di-(C₁ -C₆)alkylamino, (C₁ -C₆)alkoxy, ##STR44##

( 68 ) A compound of the formula XIV, wherein said compound is (3RS,4RS)-3-phenyl-4-(2-methoxybenzyl)amino-2-azabicyclo[3.3.1]nonane.

This invention also relates to a method of treating or preventing urinary incontinence in a mammal, including a human, comprising administering to said mammal a compound of the formula ##STR45## wherein X¹ is C₁ -C₅ alkoxy or halosubstituted (C₁ -C₅) alkoxy;

X² is hydrogen, halogen, (C₁ -C₅)alkyl, (C₂ -C₅)alkenyl, (C₂ -C₅)alkynyl, (C₁ -C₅)alkoxy, (C₁ -C₅)alkylthio, (C₁ -C₅) alkylsulfinyl, (C₁ -C₅)alkylsulfonyl, halosubstituted (C₁ -C₅) alkyl, halosubstituted (C₁ -C₅) alkoxy, (C₁ -C₅)alkylamino, dialkylamino having from 1 to 5 carbon atoms in each alkyl moiety, (C₁ -C₅)alkylsulfonylamino (which may be substituted by halogen), N-(C₁ -C₅)alkyl-N-(C₁ -C₅)alkylsulfonylamino (which may be substituted by halogen in the alkylsulfonyl moiety), (C₁ -C₅)alkanoylamino (which may be substituted by halogen) or N-(C₁ -C₅)alkyl-N-(C₁ -C₅)alkanoylamino (which may be substituted by halogen in the alkanoyl moiety);

Ar¹ and Ar₂ are each, independently, thienyl, phenyl, fluorophenyl, chlorophenyl or bromophenyl;

A is Y--(CH₂)_(m) --CH(R²)--(CH₂)_(n) --NR¹ --;

R¹ is hydrogen, (C₁ -C₅)alkyl, benzyl or --(CH₂)_(p) --Y;

R² is hydrogen, (C₁ -C₅)alkyl (which may be substituted by a substituent selected from the group consisting of hydroxy, amino, methylthio and mercapto), benzyl, 4-hydroxybenzyl, 3-indolylmethyl or --(CH₂)_(p) --Y;

Y is --CN, --CH₂ Z or --COZ;

Z is hydroxy, amino, (C₁ -C₅)alkoxy, (C₁ -C₅) alkylamino or dialkylamino having from 1 to 5 carbon atoms in each alkyl moiety;

m, n and p are each, independently, 0, 1, 2 or 3; and

R¹ and R² may be connected to form a ring.

Preferred embodiments of this invention include methods of treating or preventing urinary incontinence in a mammal, including a human, that comprise administering to said mammal an amount of a compound as defined in paragraph (69) below, that is effective in treating or preventing such condition.

(69) A compound of the formula XV, wherein said compound is selected from the group consisting of:

(3R,4S,5S,6S)-N-carbamoylmethyl-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide;

(3R,4S,5S,6S)-N-carboxymethyl-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide;

(3R,4S,5S,6S)-3-(2-carbamoylpyrrolidin-1-yl)carbonyl-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane;

(3R*,4S*,5S*,6S*)-N-(1-carbamoylethyl)-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide;

(3R,4S,5S,6S)-N-(1-carbamoyl-3-methylbutyl)-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide; and

(3R,4S,5S,6S)-N-(2-carbamoylethyl)-5-(5-isopropyl-2-methoxybenzylamino)-6-diphenylmethyl-1-azabicyclo[2.2.2]octane-3-carboxamide.

The term "halo", as used herein, unless otherwise indicated, includes chloro, fluoro, bromo and iodo.

The term "alkyl", as used herein, unless otherwise indicated, includes saturated monovalent hydrocarbon radicals having straight, branched or cyclic moieties or combinations thereof.

The term "alkenyl", as used herein, unless otherwise indicated, refers to straight or branched hydrocarbon chain radicals having one double bond including, but not limited to, ethenyl, 1- and 2-propenyl, 2-methyl-1-propenyl, 1- and 2-butenyl.

The term "alkoxy", as used herein, unless otherwise indicated, refers to -O-alkyl, wherein alkyl is defined as above, and includes, but is not limited to methoxy, ethoxy, propoxy, isopropoxy, n-butoxy, isobutoxy and t-butoxy.

The term "alkylthio", as used herein, unless otherwise indicated, refers to -S-alkyl, wherein alkyl is defined as above, and includes, but is not limited to methylthio, ethylthio, n-propylthio, isopropylthio, n-butylthio, isobutylthio, and t-butylthio.

The term "cycloalkyl", as used herein, unless otherwise indicated, refers to cyclic hydrocarbon radicals including, but not limited to cyclopropyl, cyclopropyl, cyclobutyl, cyclopentyl and cyclohexyl.

The term "one or more substituents," as used herein, includes from one to the maximum number of substituents possible based on the number of available bonding sites.

Compounds of the formulae I, X, XI, XII, XIII, XIV and XV contain chiral centers and therefore exist in different enantiomeric forms. The above definitions of these compounds include all optical isomers and all stereoisomers of such compounds, and mixtures thereof.

DETAILED DESCRIPTION OF THE INVENTION

The compounds of the formulae Ia, Ib, Ic, Id, X, XI, XII, XIII, and XIV may be prepared as described below. Unless otherwise indicated, in the discussion that follows, structural formulae Ia, Ib, Ic, Id, X, XI XII, XIII, and XIV, and groups II, III, IV, V, VI, VII, VIII and IX are defined as above.

Compounds of the formula Ia and Ib may be prepared as described in U.S. patent application Ser. No. 988,653, which was filed on Dec. 10, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula Ic may be prepared as described in U.S. patent application Ser. No. 932,392, which was filed on Aug. 19, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula Id may be prepared as described in PCT Patent Application PCT/US 92/03571, which designates the United States and was filed in the United States Receiving Office on May 5, 1992. This application is incorporated herein by reference in its entirety.

When R³ is a group of the formula II, the starting materials of the formula NH₂ R³ that are used in the preparation of compounds of the formulae Ia, Ib, Ic and Id may be prepared as described in U.S. Pat. No. 5,162,339, which issued on Nov. 11, 1992. This patent is incorporated herein by reference in its entirety.

When R³ is a group of the formula III, the starting materials of the formula NH₂ R³ that are used in the preparation of compounds of the formulae Ia, Ib, Ic and Id may be prepared as described in PCT Patent Application PCT/US 91/02853, which designates the United States, was filed in the United States Receiving Office on Apr. 25, 1991 and was published as WO 91/18899 on Dec. 12, 1991. This application is incorporated herein by reference in its entirety.

When R³ is a group of the formula IV, V or VI, the starting materials of the formula NH₂ R³ that are used in the preparation of compounds of the formulae Ia, Ib, Ic and Id may be prepared as described in PCT Patent Application PCT/US 91/03369, which designates the United States, was filed on in the United States Receiving Office May 14, 1991 and was published as WO 92/01688 on Feb. 6, 1992. This application is incorporated herein by reference in its entirety.

When R³ is a group of the formula VII, the starting materials of the formula NH₂ R³ that are used in the preparation of compounds of the formulae Ia, Ib, Ic and Id may be prepared as described in U.S. patent application Ser. No. 724,268, filed Jul. 1, 1991, U.S. patent application Ser. No. 800,667, filed Nov. 27, 1991 and PCT Patent Application PCT/US 92/00065, which designates the United States, was filed in the United States Receiving Office on Jan. 14, 1992 and was published as WO 92/17449 on Oct. 15, 1992. These applications are incorporated herein by reference in their entirety.

When R³ is a group of the formula VIII, the starting materials of the formula NH₂ R³ that are used in the preparation of compounds of the formulae Ia, Ib, Ic and Id may be prepared as described in PCT Patent Application PCT/US 91/05776, which designates the United States, was filed in the United States Receiving Office on Aug. 20, 1991 and was published as WO 92/06079 on Apr. 16, 1992, U.S. patent application Ser. No. 800,667, filed Nov. 27, 1991 and PCT Patent Application PCT/US 92/00065, which designates the United States, was filed in the United States Receiving Office on Jan. 14, 1992 and was published as WO 92/17449 on Oct. 15, 1992. These applications are incorporated herein by reference in their entirety.

When R³ is a group of the formula IX, the starting materials of the formula NH₂ R³ that are used in the preparation of compounds of the formulae Ia, Ib, Ic and Id may be prepared as described in U.S. patent application Serial No. 719,884, filed Jun. 21, 1991 and PCT Patent Application PCT/US 92/04697, which designates the United States and was filed in the United States Receiving Office on Jun. 11, 1992. These applications are incorporated herein by reference in their entirety.

Compounds of the formula X may be prepared as described in PCT Patent Application PCT/US 92/04002, which designates the United States, was filed in the United States Receiving Office on May 19, 1992 and was published as WO 92/15585 on Sep. 17, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula XI may be prepared as described in PCT Patent Application PCT/US 92/04697, which designates the United States, was filed in the United States Receiving Office on Jun. 11, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula XII may be prepared as described in PCT Patent Application PCT/US 92/07730, which designates the United States and was filed in the United States Receiving Office on Sep. 18, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula XIII may be prepared as described in PCT Patent Application PCT/US 92/06819, which designates the United States and was filed in the United States Receiving Office on Aug. 20, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula XIV may be prepared as described in U.S. patent application Ser. No. 885,110, which was filed on May 18, 1992. This application is incorporated herein by reference in its entirety.

Compounds of the formula XV may be prepared by the procedure described in Japanese Patent Application 065337/92, which was filed on Mar. 23, 1992. These procedures are depicted in Schemes 1, 2 and 3 and discussed below. In the reaction schemes and discussion that follow, A, X¹, X², Ar¹ and Ar² are defined as in the definition of compounds of the formula XV above. ##STR46##

Referring to Scheme 1, the starting materials of the formula (i) may be prepared by the procedures described in PCT Patent Application PCT/US 92/04002, which was published as WO 92/15585 on Sep. 17, 1992. This application is incorporated herein by reference in its entirety.

Introduction of a protected amino acid into a compound of the formula (i) to give a compound of the formula (ii) can be carried out by a variety of conventional methods for peptide synthesis, as described in "Peptide Synthesis, the basis and experiments", edited by N. Izumiya, 1985 (Maruzen).

Such methods include an activated ester method that employs an acid chloride or mixed acid anhydride, and a condensation method that employs an appropriate condensing agent selected from dicyclohexylcarbodiimide (DCC), water soluble carbodiimide, 2-ethoxy-N-ethoxycarbonyl-1,2-dihydroquinoline, Bop agent, diethylcyanophosphonic acid and diphenylphospolylazide.

If necessary, addition of a tertiary amide such as triethylamine can promote the condensation reaction. N-hydroxysuccinimide, N-hydroxybenzotriazole or 3,4-dihydro-3-hydroxy-4-oxo-1,2,3-benzotriazine may be employed to prevent racemization.

Typically, a compound of the formula (ii) can be prepared from a compound of the formula (i) and an amino acid or its salt, which is protected by an amino group or a mono- or dialkyl substituted amino group, by the use of a peptide coupling reagent such as DCC or diethylcyanophosphonic acid in a reaction inert solvent such as methylene chloride, THF or DMF, in the presence of triethylamine.

The resulting compound of the formula (ii) may be converted into a compound of the formula (iii) by reductive amination. This route involves direct introduction of the appropriate benzylamino group at the 3-position of the quinuclidine, and is typically conducted in two steps. In the first step, the imine formation from the compound of formula (ii) and the benzylamine is carried out by heating the reactants at the reflux temperature in a reaction inert solvent such as toluene or benzene, in the presence of catalytic amount of acid (e.g., p-toluenesulfonate or camphorsulfonic acid (CSA)) under dehydrolytic conditions. Alternatively, a Lewis acid such as aluminum chloride or titanium tetrachloride can be used as the acid catalyst. Under such catalytic conditions, and at temperatures from about -78° C. to about room temperature, it is preferable to use an acetonitrile or methylene chloride solvent together with a dehydrating agent such as molecular sieves.

In the second step, the imine is reduced to afford the compound of the formula (iii). This reduction can be carried out by either catalytic hydrogenation, or by reaction with a suitable hydride reagent such as a borohydride, borane or aluminum hydride. Typically, a reagent such as NaBH₄, NaBH₃ CN or NaBH(OAc)₃ in the presence of acetic acid is used.

The above two reaction steps can be carried out simultaneously. In such cases, the reaction is preferably carried out using NaBH₃ CN in methanol in the presence of acetic acid.

The compound of the formula (iii) can be converted into the corresponding carboxylic of formula (iv) acid by acidic hydrolysis in an inorganic acid such as hydrochloric acid at a temperature from about room temperature to about the reflux temperature for about 30 minutes to several hours.

The resulting carboxylic acid can be converted to the corresponding ester by heating it in an alcoholic solvent in the presence of an acid catalyst.

Alternatively, the compound of formula (iii) can be prepared by the procedure illustrated in Scheme 2. Referring to Scheme 2, the compound of formula (iii) can be prepared by peptide condensation from a compound of the formula (iv) and an amino acid which is protected at its carboxyl moiety. The generic synthetic condition for various peptide synthetic methods described in the above discussion of Scheme 1 can be used in this reaction.

The procedure illustrated in Scheme 3 can also be used to prepare compounds of the formula (iii). Using this procedure, compounds of the formula (iii) can be prepared by reductive amination of 3-amino quinuclidines of the formula (v) having an amino acid as the substituent A with the corresponding substituted benzaldehyde. This reductive amination reaction proceeds easily under standard reaction conditions because it goes by way of a stable imine intermediate. Use of a borane reducing agent (e.g. NaBH₃ CN or NaBH(Oac)₃ etc.) is preferred.

The starting material of formula (v) can be obtained by debenzylation of the compound of formula (iii). The debenzylation is preferably accomplished by hydrogenolysis with a palladium catalyst (e.g., palladium or palladium hydroxide) which scarcely affects the other functional groups in the compound of formula (v).

The compounds of formula (iii) prepared by the above methods can be isolated and purified by conventional procedures, such as recrystallization or chromatography.

The compounds of the formulae Ia, Ib, Ic, Id, X, XI, XII, XIII, XIV and XV (hereinafter referred to, collectively, as the "therapeutic agents of this invention") and the pharmaceutically acceptable salts thereof are useful as substance P receptor antagonists, i.e., they possess the ability to antagonize the effects of tachykinins at the substance P receptor site in mammals, and therefore they are able to function as therapeutic agents in the treatment and prevention of urinary incontinence in an afflicted mammal.

The therapeutic agents of this invention that are basic in nature are capable of forming a wide variety of different salts with various inorganic and organic acids. Examples of acids that form suitable pharmaceutically acceptable salts for use in this invention are those that form non-toxic acid addition salts, i.e., salts containing pharmacologically acceptable anions, such as the hydrochloride, hydrobromide, hydroiodide, nitrate, sulfate, bisulfate, phosphate, acid phosphate, acetate, lactate, titrate, acid citrate, tartrate, bitartrate, succinate, maleate, fumarate, gluconate, saccharate, benzoate, methanesulfonate, ethanesulfonate, benzenesulfonate, p-toluenesulfonate and pamoate [i.e., 1,1'-methylene-bis-(2-hydroxy-3-naphthoate)]salts.

Although such salts must be pharmaceutically acceptable for administration to animals, it is often desirable in practice to initially isolate a therapeutic agent of this invention from the reaction mixture as a pharmaceutically unacceptable salt and then simply convert the latter back to the free base compound by treatment with an alkaline reagent and subsequently convert the latter free base to a pharmaceutically acceptable acid addition salt. The acid addition salts of the base therapeutic agents of this invention are readily prepared by treating the base compound with a substantially equivalent amount of the chosen mineral or organic acid in an aqueous solvent medium or in a suitable organic solvent, such as methanol or ethanol. Upon careful evaporation of the solvent, the desired solid salt is readily obtained.

Those therapeutic agents of this invention that are also acidic in nature are capable of forming base salts with various pharmacologically acceptable cations. The chemical bases that are used as reagents to prepare the pharmaceutically acceptable base salts of the therapeutic agents of this invention are those that form non-toxic base salts with the acidic therapeutic agents of this invention. Such non-toxic base salts include those derived from such pharmacologically acceptable cations as sodium, potassium, calcium and magnesium, etc. These salts can easily be prepared by treating the corresponding acidic compounds with an aqueous solution containing the desired pharmacologically acceptable cations, and then evaporating the resulting solution to dryness, preferably under reduced pressure. Alternatively, they may also be prepared by mixing lower alkanolic solutions of the acidic compounds and the desired alkali metal alkoxide together, and then evaporating the resulting solution to dryness in the same manner as before. In either case, stoichiometric quantities of reagents are preferably employed in order to ensure completeness of reaction and maximum yields of the desired final product.

The therapeutic agents of this invention and their pharmaceutically acceptable salts exhibit substance P receptor-binding activity and therefore are of value in the treatment and prevention of urinary incontinence in mammals, including humans.

The therapeutic agents of this invention and the pharmaceutically acceptable salts thereof can be administered via either the oral or parenteral routes. In general, these compounds are most desirably administered in dosages ranging from about 5.0 mg up to about 1500 mg per day, although variations will necessarily occur depending upon the weight and condition of the subject being treated and the particular route of administration chosen. However, a dosage level that is in the range of about 0.07 mg to about 21 mg per kg of body weight per day is most desirably employed. Variations may nevertheless occur depending upon the species of animal being treated and its individual response to said medicament, as well as on the type of pharmaceutical formulation chosen and the time period and interval at which such administration is carried out. In some instances, dosage levels below the lower limit of the aforesaid range may be more than adequate, while in other cases still larger doses may be employed without causing any harmful side effect, provided that such larger doses are first divided into several small doses for administration throughout the day.

The therapeutic agents of this invention and their pharmaceutically acceptable salts may be administered alone or in combination with pharmaceutically acceptable carriers or diluents by either of the three routes previously indicated, and such administration may be carried out in single or multiple doses. More particularly, the novel therapeutic agents of this invention can be administered in a wide variety of different dosage forms, i.e., they may be combined with various pharmaceutically acceptable inert carriers in the form of tablets, capsules, lozenges, troches, hard candies, suppositories, aqueous suspensions, injectable solutions, elixirs, syrups, and the like. Such carriers include solid diluents or fillers, sterile aqueous media and various non-toxic organic solvents, etc. Moreover, oral pharmaceutical compositions can be suitably sweetened and/or flavored. In general, the therapeutic compounds of this invention are present in such dosage forms at concentration levels ranging from about 5.0% to about 70% by weight.

For oral administration, tablets containing various excipients such as microcrystalline cellulose, sodium citrate, calcium carbonate, dicalcium phosphate and glycine may be employed along with various disintegrants such as starch (and preferably corn, potato or tapioca starch), alginic acid and certain complex silicates, together with granulation binders like polyvinylpyrrolidone, sucrose, gelatin and acacia. Additionally, lubricating agents such as magnesium stearate, sodium lauryl sulfate and talc are often very useful for tabletting purposes. Solid compositions of a similar type may also be employed as fillers in gelatin capsules; preferred materials in this connection also include lactose or milk sugar as well as high molecular weight polyethylene glycols. When aqueous suspensions and/or elixirs are desired for oral administration, the active ingredient may be combined with various sweetening or flavoring agents, coloring matter or dyes, and, if so desired, emulsifying and/or suspending agents as well, together with such diluents as water, ethanol, propylene glycol, glycerin and various like combinations thereof.

For parenteral administration, solutions of a therapeutic agent of this invention in either sesame or peanut oil or in aqueous propylene glycol may be employed. The aqueous solutions should be suitably buffered if necessary and the liquid diluent first rendered isotonic. These aqueous solutions are suitable for intravenous injection purposes. The oily solutions are suitable for intraarticular, intramuscular and subcutaneous injection purposes. The preparation of all these solutions under sterile conditions is readily accomplished by standard pharmaceutical techniques well known to those skilled in the art.

The activity of the therapeutic compounds of the present invention as substance P receptor antagonists may be determined by their ability to inhibit the binding of substance P at its receptor sites in bovine caudate tissue, employing radioactive ligands to visualize the tachykinin receptors by means of autoradiography. The substance P antagonizing activity of the herein described compounds may be evaluated by using the standard assay procedure described by M. A. Cascieri et al., as reported in the Journal of Biological Chemistry, Vol. 258, p. 5158 (1983). This method essentially involves determining the concentration of the individual compound required to reduce by 50% the amount of radiolabelled substance P ligands at their receptor sites in said isolated cow tissues, thereby affording characteristic IC₅₀ values for each compound tested.

In this procedure, bovine caudate tissue is removed from a -70° C. freezer and homogenized in 50 volumes (w./v.) of an ice-cold 50 mM Tris (i.e., trimethamine which is 2-amino-2-hydroxymethyl-1,3-propanediol) hydrochloride buffer having a pH of 7.7. The homogenate is centrifuged at 30,000×G for a period of 20 minutes. The pellet is resuspended in 50 volumes of Tris buffer, rehomogenized and then recentrifuged at 30,000×G for another twenty-minute period. The pellet is then resuspended in 40 volumes of ice-cold 50 mM Tris buffer (pH 7.7) containing 2 mM of calcium chloride, 2 mM of magnesium chloride, 4 μg/ml of bacitracin, 4μg/ml of leupeptin, 2 μg of chymostatin and 200 g/ml of bovine serum albumin. This step completes the production of the tissue preparation.

The radioligand binding procedure is then carried out in the following manner, viz., by initiating the reaction via the addition of 100 μl of the test compound made up to a concentration of 1 μM, followed by the addition of 100 μl of radioactive ligand made up to a final concentration 0.5 mM and then finally by the addition of 800 μl of the tissue preparation produced as described above. The final volume is thus 1.0 ml, and the reaction mixture is next vortexed and incubated at room temperature (ca. 20° C.) for a period of 20 minutes. The tubes are then filtered using a cell harvester, and the glass fiber filters (Whatman GF/B) are washed four times with 50 mM of Tris buffer (pH 7.7), with the filters having previously been presoaked for a period of two hours prior to the filtering procedure. Radioactivity is then determined in a Beta counter at 53% counting efficiency, and the IC₅₀ values are calculated by using standard statistical methods.

The ability of the therapeutic compounds of this invention to inhibit substance P induced effects in vivo may be determined by the following procedures "a" through "c". (Procedures "a" through "c" are described in Nagahisa et al., European Journal of Pharmacology, 217, 191-5 (1992), which is incorporated herein by reference in its entirety.)

a. Plasma extravasation in the skin

Plasma extravasation is induced by intradermal administration of substance P (50 μl, 0.01% BSA-saline solution) in dorsal skin of pentobarbital (25 mg/kg i.p.) anesthetized male Hartley guinea pigs weighing 450-500 g. The compound to be tested is dissolved in 0.1% methyl cellulose-water (MC) and dosed p.o. 1 hour before substance P challenge (3 pmol/site). Evans blue dye (30 mg/kg) is administered intravenously 5 minutes before challenge. After 10 minutes, the animals are sacrificed, the dorsal skin is removed, and the blue spots are punched out using a cork borer (11.5 mm oral dose (o.d.)). Tissue dye content is quantitated after overnight formamide extraction at 600 nm absorbance.

b. Capsaicin-induced plasma extravasation

Plasma extravasation is induced by intraperitoneal injection of capsaicin (10 ml of 30 μM solution in 0.1% BSA/saline) into pentobarbital anesthetized (25 mg/kg i.p.) guinea pigs. The compound to be tested is dissolved in 0.1% MC and dosed p.o. 1 hour before capsaicin challenge. Evans blue dye (30 mg/kg) is administered i.v. 5 minutes before challenge. After 10 minutes, the animals are sacrificed, and both right and left ureters are removed. Tissue dye content is quantitated as in "a" above.

c. Acetic acid-induced abdominal stretching

Male ddY mice (SLC, Japan), weighing 14-18 g, were fasted overnight. The compound to be tested is dissolved in 0.1% MC and dosed p.o. 0.5 hour before acetic acid (AA) injection (0.7%, 0.16 ml/10 g body weight). The animals are placed in clear beakers (1 per beaker) and the stretching response is counted 10 to 20 minutes after the AA injection (10 minute interval). 

We claim:
 1. A method of treating or preventing urinary incontinence in a mammal, comprising administering to said mammal an amount of a compound of the formula ##STR47## wherein X¹ is hydrogen, (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms or (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms;X² and X³ are independently selected from hydrogen, halo, nitro, (C₁ -C₁₀) alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₁₀) alkoxy optionally substituted with from one to three fluorine atoms, trifluoromethyl, hydroxy, phenyl, cyano, amino, (C₁ -C₆)-alkylamino, di-(C₁ -C₆)alkylamino, ##STR48## and R³ is a group of the formula ##STR49## wherein x is an integer from zero to four; y is an integer from zero to four; z is an integer from one to six, wherein the ring containing (CH₂)_(z) may contain from zero to three double bonds, and any one of the carbons of (CH₂)_(z) may optionally be replaced by oxygen, sulfur or nitrogen; X⁴ is (CH₂)_(q) wherein q is an integer from 1 to 6, and wherein any one of the carbon-carbon single bonds in said (CH₂)_(q) may optionally be replaced by a carbon-carbon double bond, and wherein any one of the carbon atoms of said (CH₂)_(q) may optionally be substituted with R¹⁴, and wherein any one of the carbon atoms of said (CH₂)_(q) may optionally be substituted with R¹⁵ ; m is an integer from 0 to 8, and any one of the carbon-carbon single bonds of (CH₂)_(m), wherein both carbon atoms of such bond are bonded to each other and to another carbon atom in the (CH₂)_(m) chain, may optionally be replaced by a carbon-carbon double bond or a carbon-carbon triple bond, and any one of the carbon atoms of said (CH₂)_(m) may optionally be substituted with R¹⁷ ; R¹² is a radical selected from hydrogen, (C₁ -C₆) straight or branched alkyl, (C₃ -C₇)cycloalkyl wherein one of the carbon atoms may optionally be replaced by nitrogen, oxygen or sulfur; aryl selected from biphenyl, phenyl, indanyl and naphthyl; heteroaryl selected from thienyl, furyl, pyridyl, thiazolyl, isothiazolyl, oxazolyl, isoxazolyl, triazolyl, tetrazolyl and quinolyl; phenyl-(C₂ -C₆)alkyl, benzhydryl and benzyl, wherein the point of attachment on R¹² is a carbon atom unless R¹² is hydrogen, and wherein each of said aryl and heteroaryl groups and the phenyl moieties of said benzyl, phenyl-(C₂ -C₆)alkyl and benzhydryl may optionally be substituted with one or more substituents independently selected from halo, nitro, (C₁ -C₁₀)alkyl optionally substituted with from one to three fluorine atoms, (C₁ -C₁₀)alkoxy optionally substituted with from one to three fluorine atoms, amino, hydroxy-(C₁ -C₆)alkyl, (C₁ -C₆)alkoxy-(C₁ -C₆)alkyl, (C₁ -C₆)-alkylamino, ##STR50## and wherein one of the phenyl moieties of said benzhydryl may optionally be replaced by naphthyl, thienyl, furyl or pyridyl; R¹³ is hydrogen, phenyl or (C₁ -C₆)alkyl; or R¹² and R¹³, together with the carbon to which they are attached, form a saturated carbocyclic ring having from 3 to 7 carbon atoms wherein one of said carbon atoms that is neither the point of attachment of the spiro ring nor adjacent to it may optionally be replaced by oxygen, nitrogen or sulfur; R¹⁴ and R¹⁵ are each independently selected from hydrogen, hydroxy, halo, amino, oxo (═O), cyano, hydroxy-(C₁ -C₆)alkyl, (C₁ -C₆)alkoxy-(C₁ -C₆)alkyl, (C₁ -C₆)alkylamino, ##STR51## and the radicals set forth in the definition of R¹² ; R¹⁶ is ##STR52## NHCH₂ R¹⁸, SO₂ R¹⁸, GR²⁰ CO₂ H or one of the radicals set forth in any of the definitions of R¹², R¹⁴ and R¹⁵ ; R¹⁷ is oximino (═NOH) or one of the radicals set forth in any of the definitions of R¹², R¹⁴ and R¹⁵ ; and R¹⁸ is (C₁ -C₆)alkyl, hydrogen, phenyl or phenyl (C₁ -C₆)alkyl; G is selected from the group consisting of CH₂, nitrogen, oxygen, sulfur and carbonyl; R²⁰ is a monocyclic or bicyclic heterocycle selected from the group consisting of pyrimidinyl, benzoxazolyl, 2,3-dihydro-3-oxobenzisosulfonazol-2-yl, morpholin-1-yl, thiomorpholin-1-yl, benzofuranyl, benzothienyl, indolyl, isoindolyl, isoquinolinyl, furyl, pyridyl, isothiazolyl, oxazolyl, triazolyl, tetrazolyl, quinolyl, thiazolyl, thienyl, and groups of the formulae ##STR53## wherein B and D are selected from carbon, oxygen, and nitrogen and at least one of B and D is other than carbon; E is carbon or nitrogen; n is an integer from 1 to 5; and any one of the carbons of the (CH₂)_(m) or (CH₂)_(n+1) may be optionally substituted with (C₁ -C₆)alkyl or (C₂ -C₆) spiroalkyl, and either any two of the carbon atoms of said (CH₂)_(n) and (CH₂)_(n+1) may be bridged by a one or two carbon atom linkage, or any one pair of adjacent carbons of said (CH₂)_(n) and (CH₂)_(n+1) may form, together with from one to three carbon atoms that are not members of the carbonyl containing ring, a (C₃ -C₅) fused carbocyclic ring; with the proviso that (a) when m is 0, one of R¹⁶ and R¹⁷ is absent and the other is hydrogen, (b) when R³ is a group of the formula VIII, R¹⁴ and R¹⁵ cannot be attached to the same carbon atom, (c) when R¹⁴ and R¹⁵ are attached to the same carbon atom, then either each of R¹⁴ and R¹⁵ is independently selected from hydrogen, fluoro, (C₁ -C₆)alkyl, hydroxy-(C₁ -C₆)alkyl and (C₁ -C₆)alkoxy-(C₁ -C₆)alkyl, or R¹⁴ and R¹⁵, together with the carbon to which they are attached, form a (C₃ -C₆) saturated carbocyclic ring that forms a spiro compound with the nitrogen-containing ring to which the are attached; (d) R¹² and R¹³ cannot both be hydrogen; (e) when R¹⁴ or R¹⁵ is attached to a carbon atom of X⁴ or (CH₂)_(y) that is adjacent to the ring nitrogen, then R.sup. 14 or R¹⁵, respectively, must be a substituent wherein the point of attachment is a carbon atom; and (f) neither R¹⁴, R¹⁵, R¹⁶ nor R¹⁷ can form a ring with R¹³ ; or a pharmaceutically acceptable salt thereof, effective in treating or preventing such condition.
 2. A method according to claim 1, wherein R³ in the compound of formula Id that is employed is a group of the formula VII.
 3. A method for treating or preventing urinary incontinence in a mammal, comprising administering to said mammal an amount of a compound selected from the group consisting of:(2S,3S)-3-(5-tert-butyl-2-methoxybenzyl)amino-2-(3-trifluoromethoxyphenyl)piperidine; (2S,3S)-3-(2-isopropoxy-5-trifluoromethoxybenzyl)amino-2-phenyl-piperidine; (2S,3S)-3-(2-ethoxy-5-trifluoromethoxybenzyl)amino-2-phenyl-piperidine; (2S,3S)-3-(2-methoxy-5-trifluoromethoxybenzyl)-amino-2-phenylpiperidine; (2S,3S)-3(-5-tert-butyl-2-trifluoromethoxybenzyl)amino-2-phenylpiperidine; 2-(diphenylmethyl)-N-(2-methoxy-5-trifluoromethoxyphenyl)methyl-1-azabicyclo[2.2.2]octan-3-amine; (2S,3S)-3-[5-chloro-2-(2,2,2-trifluoroethoxy)benzyl]amino-2-phenylpiperidine; (2S,3S)-3-(5-tert-butyl-2-trifluoromethoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(2-isopropoxy-5-trifluoromethoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(2-difluoromethoxy-5-trifluoromethoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-2-phenyl-3-[2-(2,2,2-trifluoroethoxybenzyl)aminopiperidine; and (2S,3S)-2-phenyl-3-(2-trifluoromethoxybenzyl)]aminopiperidine; or a pharmaceutically acceptable salt thereof, that is effective in treating or preventing such condition.
 4. A method for treating or preventing urinary incontinence in a mammal, comprising administering to said mammal an amount of a compound selected from the group consisting of:cis-3-(2-chlorobenzylamino)-2-phenylpiperidine; cis-3-(2-trifluoromethylbenzylamino)-2-phenylpiperidine; cis-3-(2-methoxybenzylamino)-2-(2-fluorophenyl)piperidine; cis-3-(2-methoxybenzylamino)-2-(2-chlorophenyl)piperidine; cis-3-(2-methoxybenzylamino)-2-(2-methylphenyl)piperidine; cis-3-(2-methoxybenzylamino)-2-(3-methoxyphenyl)-piperidine; cis-3-(2-methoxybenzylamino)-2-(3-fluorophenyl)-piperidine; cis-3-(2-methoxybenzylamino)-2-(3-chlorophenyl)-piperidine; cis-3-(2-methoxybenzylamino)-2-phenylpiperidine; cis-3-(2-methoxybenzylamino)-2-(3-methylphenyl)piperidine; cis-3-(2-methoxybenzylamino)-2-(4-fluorophenyl)piperidine; cis-3-(2-methoxybenzylamino)-2-(3-thienyl)-piperidine; cis-3-(2-methoxybenzylamino)-2-phenylazacyclo-heptane; 3-(2-methoxybenzylamino)-4-methyl-2-phenyl-piperidine; 3-(2-methoxybenzylamino)-5-methyl-2-phenyl-piperidine; 3-(2-methoxybenzylamino)-6-methyl-2-phenyl-piperidine; (2S,3S)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(5-carboethoxypent-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(6-hydroxy-hex-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(4-hydroxy-4-phenylbut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(4-oxo-4-phenylbut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(5,6-dihydroxyhex-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; cis-3-(5-fluoro-2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-[4-(4-fluorophenyl)-4-oxobut-1-yl]-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-[4-[4-fluorophenyl)-4-hydroxybut-1-yl]-3-(2-methoxybenzylamino)-2-phenylpiperidine; cis-3-(2-methoxy-5-methylbenzylamino)-2-phenylpiperidine; (2S,3S)-1-(4-benzamidobut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; cis-3-(2-methoxynaphth-1-ylmethylamino)-2-phenylpiperidine; (2S,3S)-3-(2-methoxybenzylamino)-1-(5-N-methylcarboxamidopent-1-yl)-2-phenylpiperidine; (2S,3S)-1-(4-cyanobut-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-[4-(2-naphthamido)but-1-yl]-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(5-benzamidopent-1-yl)-3-(2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-1-(5-aminopent-1-yl)-3-(2-methoxybenzylamino)2-phenylpiperidine; (2S,3S)-3-(5-chloro-2-methoxybenzylamino)-2-phenylpiperidine; (2S,3S)-3-(2,5-dimethoxybenzylamino)-2-phenylpiperidine; cis-3-(3,5-difluoro-2-methoxybenzylamino)-2-phenylpiperidine; cis-3-(4,5-difluoro-2-methoxybenzylamino)-2-phenylpiperidine; cis-3-(2,5-dimethoxybenzylamino)-1-[4-(4-fluorophenyl)-4-oxobut-1-yl]-2-phenylpiperidine; cis-3-(5-chloro-2-methoxybenzylamino)-1-(5,6-dihydroxyhex-1-yl)-2-phenylpiperidine; cis-1-(5,6-dihydroxyhex-1-yl)-3-(2,5-dimethoxybenzylamino)-2-phenylpiperidine; cis-2-phenyl-3-[-2(prop-2-yloxy)benzylamino]piperidine; cis-3-(2,5-dimethoxybenzyl)amino-2-(3-methoxyphenyl)piperidine hydrochloride; cis-3-(5-chloro-2-methoxybenzyl)amino-2-(3-methoxyphenyl)piperidine dihydrochloride; cis-3-(5-chloro-2-methoxybenzyl)amino-2-(3-chlorophenyl)piperidine dihydrochloride; 3-(2-methoxybenzylamino)-2,4-diphenylpiperidine; cis-3-(2-methoxybenzylamino)-2-phenylpyrrolidine; (2S,3S)-3-(5-ethyl-2-methoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(5-n-butyl-2-methoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(2-methoxy-5-n-propylbenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(5-isopropyl-2-methoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(5-s-butyl-2-methoxybenzyl)amino-2-phenylpiperidine; (2S,3S)-3-(5-t-butyl-2-methoxybenzyl)amino-2-phenylpiperidine; and (2S,3S)-3-(2-methoxy-5-phenylbenzyl)amino-2-phenylpiperidine; or a pharmaceutically acceptable salt thereof, that is effective in preventing or treating such condition. 